Chest
Original ResearchCritical Care MedicineIntentional Leaks in Industrial Masks Have a Significant Impact on Efficacy of Bilevel Noninvasive Ventilation: A Bench Test Study
Section snippets
Assessment of Intentional Leaks of the Masks
Seven industrial masks were tested: the nasal FlexiFit 405 and the facial FlexiFit 431 (Fischer & Paykel Healthcare; Auckland, New Zealand), the nasal Ultra Mirage and the facial Ultra Mirage (ResMed; NorthRyde, Australia), the nasal ComfortClassic and the facial ComfortFull (Respironics; Monroeville, PA), and the nasal IQ SleepNet (L3-Médical; Vienne, France). The intentional leak valve of each mask was isolated from the mask and adapted on a tight support. This support was connected to a CPAP
Results
Mean ± SD values of TD, trigger PTP, PTP500, Ti-assist, and Vt are given in Table 1, Table 2, Table 3 in normal, restrictive, and obstructive simulated lung mechanics, respectively. ρ values (Spearman rank sum test), listed when significant, quantify for each ventilator the correlation between these parameters and the importance of intentional leaks among the seven tested masks. The relationship for PTP500 and Vt for all four ventilators tested, and relationship between the importance of
Discussion
Nonintentional leaks, occurring during NIV, have a detrimental effect on efficacy of NIV in both acute and chronic conditions.14, 15, 16 To our knowledge, the present study is the first to assess a wide range of masks with different intentional leaks and analyze the consequences of increasing intentional leaks on trigger efficacy, capacity to achieve and maintain preset pressure, and inspiratory/expiratory cycling. Our results can be summarized as follows: (1) within a 30 to 45 L/min range (at
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The authors have no conflicts of interest to disclose.
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